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Gender-Related Differences in Presentation, Treatment, and Outcome of Patients With Atrial Fibrillation in Europe. A Report From the Euro Heart Survey on Atrial Fibrillation
Authors
N. Dagres Nieuwlaat, R. Vardas, P.E. Andresen, D. Lévy, S. Cobbe, S. Kremastinos, D.Th. Breithardt, G. Cokkinos, D.V. Crijns, H.J.G.M. Camm, A.J. Davies, W. Capucci, A. Olsson, B. Aliot, E. Le Heuzey, J.-Y. Santini, M. Manini, M. Bramley, C. Laforest, V. Taylor, C. Del Gaiso, S. Huber, K. De Backer, G. Sirakova, V. Cerbak, R. Thayssen, P. Lehto, S. Blanc, J.-J. Delahaye, F. Kobulia, B. Zeymer, U. Karlocai, K. Graham, I. Shelley, E. Behar, S. Maggioni, A. Gonc¸alves, L. Grabauskiene, V. Asmussen, I. Deckers, J. Stepinska, J. Mareev, V. Vasiljevic, Z. Riecansky, I. Kenda, M.F. Alonso, A. Lopez-Sendon, J.L. Rosengren, A. Buser, P. Okay, T. Sychov, O. Fox, K. Schofield, P. Simoons, M. Wood, D. Battler, A. Boersma, E. Fox, K. Komajda, M. McGregor, K. Mulder, B. Priori, S. Ryde´n, L. Vahanian, A. Wijns, W. Sanofi-Aventis Grigoryan, S.V. Apetyan, I. Aroyan, S. Azarapetyan, L. Anvari, A. Gottsauner-Wolf, M. Pfaffenberger, S. Aydinkoc, K. Kalla, K. Penka, M. Drexel, H. Langer, P. Pierard, L.A. Legrand, V. Blommaert, D. Schroeder, E. Mancini, I. Geelen, P. Brugada, P. De Zutter, M. Vrints, C. Vercammen, M. Morissens, M. Borisov, B. Petrov, V.A. Marinova, M. Assen, A. Goudev, R. Peychev, Y. Stoyanovsky, V. Stoynev, E. Kranjcevic, S. Moutiris, J. Ioannides, M. Evequoz, D. Spacilova, J. Novak, M. Eisenberger, M. Mullerova, J. Kautzner, J. Riedlbauchova, L. Petru`, J. Taborsky, M. Cappelen, H. Sharaf, Y.A. Ibrahim, B.S.S. Tammam, K. Saad, A. Elghawaby, H. Sherif, H.Z. Farouk, H. Mielke, A. Engelen, M. Kirchhof, P. Zimmermann, P. Aviles, F.F. Rubio, J. Malpartida, F. Corona, M. Sanchez, L.T. Miguel, J. Herrera, L. Quesada, A. Garcia, A.J.M. Gonzalez, C.S. Juango, M.S.A. Berjon-Reyero, J. Alegret, J.M. Fernandez, J.M.C. Carrascosa, C. Romero, R.A.F. Lara, M.G. Sendon, J.L.L. de Diego, J.J.G. Martin, L.S. Irurita, M. Guttierez, N.H. Rubio, J.R.S. Antorrena, I. Paves, A.B. Salvador, A. Orriach, M.D. Garcia, A.A. Epelde, F. Martinez, V.B. Sanchez, A.B. Galvez, C.P. Rivero, R.F. Madrid, A.H. Baron-Esquivias, G. Peinado, R. Guindal, J.A.G. Vera, T.R. Fernandez, E.L. Gayan, R. Garcia, J. Bodegas, A. Lopez, J.T. Florez, J.M. Cabezas, C.L. de Castroviejo, E.V.R. Bellido, J.M. Ruiz, M.E. Savolainen, K. Nieminen, M. Toivonen, L. Syvanne, M. Pietila, M. Galley, D. Beltra, C. Gay, A. Daubert, J.C. Lecocq, G. Poulain, C. Cleland, J.G.F.C. Shelton, R. Choudhury, A. Abuladze, G. Jashi, I. Tsiavou, A. Giamouzis, G. Kostopoulou, A. Tsoutsanis, D. Stefanadis, C. Latsios, G. Vogiatzis, I. Gotsis, A. Bozia, P. Karakiriou, M. Koulouris, S. Parissis, J. Kostakis, G. Kouris, N. Kontogianni, D. Athanasios, K. Douras, A. Tsanakis, T. Marketou, M. Patsourakos, N. Czopf, L. Halmosi, R. Pre´da, I. Csoti, E. Badics, A. Strasberg, B. Freedberg, N.A. Katz, A. Zalzstein, E. Grosbard, A. Goldhammer, E. Nahir, M. Epstein, M. Vider, I. Luria, D. Mandelzweig, L. Aloisi, B. Cavallaro, A. Antonielli, E. Doronzo, B. Pancaldo, D. Mazzola, C. Buontempi, L. Calvi, V. Giuffrida, G. Figlia, A. Ippolito, F. Gelmini, G.-P. Gaibazzi, N. Ziacchi, V. De Tommasi, F. Lombardi, F. Fiorentini, C. Terranova, P. Maiolino, P. Albunni, M. Pinna-Pintor, P. Fumagalli, S. Masotti, G. Boncinelli, L. Rossi, D. Santoro, G.M. Fioranelli, M. Naccarella, F. Maranga, S.S. Lepera, G. Bresciani, B. Seragnoli, E. Forti, M.C. Cortina, V. Baciarello, G. Cicconetti, P. Lax, A. Vitali, F. Igidbashian, D. Scarpino, L. Terrazzino, S. Tavazzi, L. Cantu, F. Pentimalli, F. Novo, S. Coppola, G. Zingarini, G. Ambrozio, G. Moruzzi, P. Callegari, S. Saccomanno, G. Russo, P. Carbonieri, E. Paino, A. Zanetta, M. Barducci, E. Cemin, R. Rauhe, W. Pitscheider, W. Meloni, M. Marchi, S.M. Di Gennaro, M. Calcagno, S. Squaratti, P. Quartili, F. Bertocchi, P. De Martini, M. Mantovani, G. Komorovsky, R. Desideri, A. Celegon, L. Tarantini, L. Catania, G. Lucci, D. Bianchini, F. Puodziukynas, A. Kavoliuniene, A. Barauskiene, V. Aidietis, A. Barysiene, J. Vysniauskas, V. Zukauskiene, I. Kazakeviciene, N. Georgievska-Ismail, L. Poposka, L. Vataman, E. Grosu, A.A. op Reimer, W.S. de Swart, E. Lenzen, M. Jansen, C. Brons, R. Tebbe, H. van Hoogenhuyze, D.C.A. Veerhoek, M.J. Kamps, M. Haan, D. van Rijn, N. Bootsma, A. Baur, L. van den, A. Fransen, H. Eurlings, L. Meeder, J. De Boer, M.J. Winter, J. Broers, H. Werter, C. Bijl, M. Versluis, S. Milkowska, M. Wozakowska-Kaplon, B. Janion, M. Lepska, L. Swiatecka, G. Kokowicz, P. Cybulski, J. Gorecki, A. Szulc, M. Rekosz, J. Manczak, R. Wnuk-Wojnar, A.-M. Trusz-Gluza, M. Rybicka-Musialik, A. Myszor, J. Szpajer, M. Cymerman, K. Sadowski, J. Sniezek-Maciejewska, M. Ciesla-Dul, M. Gorkiewicz-Kot, I. Grodzicki, T. Rewiuk, K. Kubik, L. Lewit, J. de Sousa, J.M.F.R. Ferreira, R. Freitas, A. Morais, J.C.A. Pires, R. Gomes, M.J.V. Gago, P. Candeias, R.A.C. Nunes, L. Sa, J.V.M. Ventura, M. de Oliveira, M. Alves, L.B. Bostaca, I. Olariu, C.T. Dan, G.A. Dan, A. Podoleanu, C. Frigy, A. Georgescu, G.I.M. Arsenescu, C. Statescu, C. Sascau, R. Dimitrascu, D.L. Rancea, R. Shubik, Y.V. Duplyakov, D. Shalak, M. Danielyan, M. Galyavich, A. Zakirova, V. Hatala, R. Kaliska, G. Kmec, J. Zupan, I. Tasie`, J. Vokac, D. Edvardsson, N. Poci, D. Gamra, H. Denguir, H. Sepetoglu, A. Arat-Ozkan, A. Orynchak, M. Paliy, E. Vakalyuk, I. Malidze, D. Prog, R. Yabluchansky, M.I. Makienko, N.V. Potpara, T. Knezevic, S. Randjelovic, M.
Publication date
1 January 2007
Publisher
Abstract
Objectives: This study sought to investigate gender-related differences in patients with atrial fibrillation (AF) in Europe. Background: Gender-related differences may play a significant role in AF. Methods: We analyzed the data of 5,333 patients (42% female) enrolled in the Euro Heart Survey on Atrial Fibrillation. Results: Compared with men, the women were older, had a lower quality of life (QoL), had more comorbidities, more often had heart failure (HF) with preserved left ventricular systolic function (18% vs. 7%, p < 0.001), and less often had HF with systolic dysfunction (17% vs. 26%, p < 0.001). Among patients with typical AF symptoms (56% of women, 49% of men), there was no gender-related difference in the choice of rate or rhythm control. Among patients with atypical or no symptoms (44% of women, 51% of men), women less frequently underwent rhythm control (39% vs. 51%, p < 0.001) than did men. Women underwent less electrical cardioversion (22% vs. 28%, p < 0.001). Prescription of oral anticoagulants was identical (65%) in both genders. One-year outcome was similar except that women had a higher chance for stroke (odds ratio 1.83 in multivariable regression analysis, p = 0.019). Conclusions: Women with AF had more comorbidities, more HF with preserved systolic function, and a lower QoL than men. In the large group with atypical or no symptoms, women were treated appropriately more conservatively with less rhythm control than men. Women had a higher chance for stroke. Long-term QoL changes and other morbidities and mortality were similar. © 2007 American College of Cardiology Foundation
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